– 7 year old male German Shephard with history of periocular eye swelling and exophthalmos
– initially thought to have a retrobulbar abscess and treated by rDVM with antibiotics
– got slightly better but then worse and not responding to antibiotics; firm swelling now inolving most of the periocular region
– rDVM performed FNA – mass very firm and mostly RBC’s retrieved. Skull rads show soft tissue swelling
– 7 year old male German Shephard with history of periocular eye swelling and exophthalmos
– initially thought to have a retrobulbar abscess and treated by rDVM with antibiotics
– got slightly better but then worse and not responding to antibiotics; firm swelling now inolving most of the periocular region
– rDVM performed FNA – mass very firm and mostly RBC’s retrieved. Skull rads show soft tissue swelling
Ultrasound of the swollen region showed a fairly homogeneous mass with what looks like multple mineral foci. The underlying bone does not look smooth, but rather quite jagged at the margins making me think that this is invading the periosteum? Does this look to be invading the bone?
I have recommended CT scan and either core or surgical biopsy but don’t think the owners are going to go further on this one to get a definitive diagnosis. Possible sarcoma of some sort? I think very aggressive surgey would be needed to deal with this one.
Comments
The multifocal
The multifocal mineralizations suggest carcoinoma and the periosteum is thick and irregular so at least attached to the bone and causing disruption of the periosteum. In the middle of the image 2 cm depth looks like there is a lytic bony disruption wiht that hypoechoic center. FNA 25 gauge is the way to go here and CT to assess how far its infiltrated.
The multifocal
The multifocal mineralizations suggest carcoinoma and the periosteum is thick and irregular so at least attached to the bone and causing disruption of the periosteum. In the middle of the image 2 cm depth looks like there is a lytic bony disruption wiht that hypoechoic center. FNA 25 gauge is the way to go here and CT to assess how far its infiltrated.